Associations Of Visceral Fat Accumulation With The Presence Of Depressive Symptoms And Serum Fibroblast Growth Factor 19 Levels

Objective:Among all obesity types,abdominally obese has the greatest impact on health and is closely related to cardiovascular disease.Recent studies have indicated that depressive symptoms often coexists with chronic diseases such as obesity and diabetes.The fibroblast growth factor 19(FGF19),an intestinal hormone,plays an important role in the regulation of energy metabolism.This study focused on the relationships between visceral obesity and the presence of depressive symptoms and serum FGF19 levels.Methods:All of the participants came from the community population in Shanghai.Abdominal fat content was detected by magnetic resonance imaging,including Visceral fat area(VFA)and Subcutaneous fat area(SFA).Subjects with a VFA?80 cm~2 were classified as viscerally obese.Depressive symptoms were evaluated with Zung's Self-Rating Depression Scale.Serum FGF19 levels were detected via quantitative sandwich enzymelinked immunosorbent assay.Results:(1)A total of 437 normoglycemic postmenopausal women were enrolled in the present study,including 117 individuals with depressive symptoms and 320individuals without depressive symptoms.The prevalence of visceral obesity in women with depressive symptoms was much higher than that in those without depressive symptoms(37.6%vs 27.5%;P=0.042).Participants with depressive symptoms showed elevated VFA values(74.6±29.8 vs 65.9±28.9 cm~2;P=0.006).Multivariate stepwise regression analysis demonstrated that VFA was independently correlated with the presence of depressive symptoms(standardized?=0.099,P=0.012).(2)In all,2383 participants were divided into subgroups of glucose tolerance status:normal glucose tolerance(NGT,n=1754),impaired glucose regulation(IGR,n=499),and newly diagnosed diabetes mellitus(DM,n=130).They were further stratified into quartiles of serum FGF19 levels(Q1-Q4).Serum FGF19 levels showed a downtrend across the NGT,IGR,and DM groups(P for trend=0.016).VFA was an independent and negative factor of serum FGF19 levels(standardized?=-0.108,P=0.001).After adjustment for glucose tolerance status,VFA differed significantly among FGF19 quartiles(P<0.001),showing a downtrend from Q1to Q4.The associations of serum FGF19 levels and glucose tolerance status with VFA were independent of each other.After adjustment for insulin resistance and secretory function separately,VFA still decreased significantly from Q1 to Q4(all P<0.001).Conclusions:In postmenopausal women,visceral fat accumulation was an independent and positive factor significantly associated with the presence of depressive symptoms.Serum FGF19 levels were related to visceral fat accumulation.Independent of glucose tolerance status,serum FGF19 levels were inversely associated with VFA.